First you notice that you have vision problems, and everything looks blurred. Colors may not bright as they did before. You know something is wrong, and you know that you need to take action.
What is cataract surgery?
First you should know what a cataract is. A cataract is a cloudy layer that forms on the eye's lens, which is between the front and back areas of the eye. Cataract surgery is an operation which successfully restores vision by removing the lens and replacing it with an artificial lens. You should know that cataract surgery is a routine procedure that has a very high success rate — 9 out of 10 people who have cataract surgery regain very good vision, somewhere between 20/20 and 20/40.
During the surgery, an eye doctor removes the clouded lens from your eye and replaces the lens with an artificial lens. Cataract surgery will significant improve your vision. Cataract surgery is a simple, relatively painless procedure to regain vision. Every surgery involves some risk. You should choose surgeon with experience, which will reduce the risk of something going wrong. After the surgery, your eyes will be bandaged as they heal. When the bandages come off, you will need to wear sunglasses for some time to protect the sensitive eyes.
When is time for cataract surgery?
You and your ophthalmologist must work together to decide this. If cataracts progress rapidly (as often happens due to complications of diabetes), don’t wait for cataract surgery. But, if your vision is still quite good, you may not need cataract surgery immediately. You need to continue to visit your ophthalmologist regularly. You should know that some cataracts never really reach the stage where they should be removed.
With cataracts, the best time for surgery is individual. Think about how your cataracts affect your life. If your cataracts don’t bother you a lot, and you can still see quite well, you can wait some time for surgery. Think about surgery when your cataracts have progressed enough to seriously impair your vision. If cataracts have a significant effect on your daily activities, you should have cataract surgery as soon as possible.
In some cases a cataract should be removed even if it doesn't cause major problems with vision, but interferes with diabetic retinopathy or retinal detachment or some other eye problems. You may have cataracts in both eyes. You will have two separate surgeries in this case, as one eye is treated first, allowed to heal, and then the next eye is tackled.
How is cataract surgery performed?
In some cases a cataract may be removed without implanting an artificial lens. During the surgery in most cases, the eye doctor removes the clouded lens from your eye and then replaces the lens with an artificial lens.
Before a cataract surgery, your ophthalmologist will measure the size and shape of your eye to determine the proper power of the lens implant. This procedure is a painless, as this is an ultrasound test.
Local or general anesthesia
Cataract surgery takes less than an hour to perform. Most patients are awake and need only local anesthesia. In rare cases some people may need general anesthesia.
Methods used to remove cataracts
Surgical methods used to remove cataracts include: phacoemulsification and extracapsular cataract extraction.
During the phacoemulsification surgeon removes the cataract but leaves most of the lens capsule in place.
During phacoemulsification, your surgeon makes a small incision, about 3 mm, where the cornea meets the conjunctiva and inserts a probe. Probe transmits ultrasound waves, to break up the cataract and suction out the fragments. The lens capsule provides support for the lens implant.
If phacoemulsification can’t be done, another method is used. Your surgeon may do an extracapsular cataract extraction. The extracapsular cataract extraction requires a larger incision, about 10 mm. Surgeon opens the lens capsule, removes the nucleus in one piece and vacuums out the softer lens cortex, leaving the capsule in place.
When the cataract has been removed by one method, a clear artificial lens is implanted into the empty lens capsule. This implant is an intraocular lens, is made of plastic, acrylic or silicone. Intraocular lens becomes a permanent part of your eye. You will need reading glass after surgery.
Intraocular lens are being developed all the time to make the surgery less complicated and the lenses more helpful to patients. New intraocular lens lets patients see at all distances, not just one. Another new intraocular lens blocks both ultraviolet and blue light rays, which research indicates may damage the retina. There are different intraocular lenses, multifocal and blue-blocking lenses. Multifocal lenses offer well near and distance vision. Glare can be problem with multifocal lenses.
After cataract surgery
With phacoemulsification surgical incisions are very small. If all goes well, you'll heal fast and your vision will start to improve within a few days. If you had extracapsular cataract extraction which requires a larger incision full healing can take up to eight weeks.
You can go home on the same day of your surgery. You must know that you can’t drive, so make sure to arrange for a ride home. You should provide necessary help, because your doctor may limit some activities for a few days. You will see your doctor the next day, the following week and then after a month.
You will feel itching and mild discomfort for a couple of days after surgery. Don’t rub or press your eye. You may wear a protective shield the day of surgery. Ophthalmologist may prescribe medications to prevent infection and control eye pressure. After a few days, all discomfort should disappear. In most off cases complete healing occurs within eight weeks.
You should contact your doctor if you have following symptoms. They include: vision loss, increased eye redness, pain that persists despite the use of medications, light flashes or multiple floaters in front of your eye, nausea, vomiting or excessive coughing.
Ophthalmologist will let you know when your eyes have healed enough for you to get a final prescription for eyeglasses. Most people need to wear glasses after cataract surgery. Astigmatism is a common complication of the surgery but is less of a problem when the procedure involves a small incision.
If you have cataracts in both eyes, after first eye surgery you need a month or two before you can schedule surgery for the other eye.
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Complications after cataract surgery
Complications after cataract surgery include: swelling, inflammation, infection, bleeding retinal detachment and glaucoma. Complications after surgery are rare and can be treated. In some cases cataract surgery doesn’t improve vision because of underlying eye damage (glaucoma or macular degeneration). If other eye problems are present, they must be evaluated and treated, before you decide to have cataract surgery.
The second cataract occurs when the back of the lens capsule becomes cloudy and impairs vision. This condition is called posterior capsule opacification. Posterior capsule opacification can develop months or years after cataract surgery.
Treatment involves a technique called YAG laser capsulotomy. This procedure is a short, painless outpatient procedure that usually takes less than five minutes. After procedure patient stay in the doctor's office for about an hour to make sure your eye pressure doesn't increase. In some people, YAG laser surgery can raise eye pressure.